Extent of thyroidectomy and paratracheal lymph node dissection in total pharyngolaryngectomy for pyriform sinus cancer, and recurrence, survival, and postoperative hypoparathyroidism: A multicenter retrospective study
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- Yosuke Ariizumi
- Department of Head and Neck Surgery Tokyo Medical and Dental University Tokyo Japan
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- Nobuhiro Hanai
- Department of Head and Neck Surgery Aichi Cancer Center Hospital Nagoya Japan
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- Takahiro Asakage
- Department of Head and Neck Surgery Tokyo Medical and Dental University Tokyo Japan
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- Akira Seto
- Division of Head and Neck Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo Japan
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- Toshifumi Tomioka
- Department of Head and Neck Surgery National Cancer Center Hospital East Kashiwa Japan
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- Junji Miyabe
- Department of Head and Neck Surgery Osaka International Cancer Institute Osaka Japan
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- Hisashi Kessoku
- Department of Otorhinolaryngology The Jikei University School of Medicine Tokyo Japan
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- Takashi Mukaigawa
- Division of Head and Neck Surgery Shizuoka Cancer Center Shizuoka Japan
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- Go Omura
- Department of Head and Neck Surgery National Cancer Center Hospital Tokyo Japan
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- Masanori Teshima
- Department of Otolaryngology – Head and Neck Surgery Kobe University Graduate School of Medicine Kobe Japan
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- Daisuke Nishikawa
- Department of Head and Neck Surgery Aichi Cancer Center Hospital Nagoya Japan
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- Yuki Saito
- Department of Otolaryngology – Head and Neck Surgery University of Tokyo Tokyo Japan
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- Yukinori Asada
- Department of Head and Neck Surgery Miyagi Cancer Center Natori Japan
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- Takuo Fujisawa
- Department of Otorhinolaryngology – Head and Neck Surgery Kansai Medical University Osaka Japan
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- Takuma Makino
- Department of Otolaryngology – Head and Neck Surgery Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
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- Hiroshi Nishino
- Otolaryngology Head and Neck Surgery Jichi Medical University Shimotsuke City Japan
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- Daisuke Sano
- Department of Otorhinolaryngology – Head and Neck Surgery Yokohama City University School of Medicine Yokohama Japan
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- Mitsuhiko Nakahira
- Department of Head Neck Surgery Saitama Medical University International Medical Cancer Saitama Japan
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- Kunihiko Tokashiki
- Department of Head and Neck Surgery Tokyo Medical University Tokyo Japan
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- Hirokazu Uemura
- Department of Otolaryngology – Head and Neck Surgery Nara Medical University Kashihara Japan
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- Tsutomu Ueda
- Department of Otorhinolaryngology – Head and Neck Surgery Hiroshima University Hospital Hiroshima Japan
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- Akihiro Sakai
- Department of Otolaryngology – Head and Neck Surgery Tokai University Isehara Japan
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- Muneyuki Masuda
- Department of Head and Neck Surgery National Hospital Organization Kyushu Cancer Center Fukuoka Japan
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- Takahiro Tsujikawa
- Department of Otolaryngology – Head and Neck Surgery Kyoto Prefectural University of Medicine Kyoto Japan
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- Yusuke Hiei
- Department of Otolaryngology – Head and Neck Surgery, School of Medicine Fujita Health University Toyoake Japan
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- Naoki Nishio
- Department of Otorhinolaryngology Nagoya University Graduate School of Medicine Nagoya Japan
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- Hidetoshi Matsui
- Department of Head and Neck Surgery Hyogo Cancer Center Akashi Japan
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- Naomi Kiyota
- Department of Medical Oncology and Hematology Kobe University Hospital Kobe Japan
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- Akihiro Homma
- Department of Otolaryngology – Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine Hokkaido University Sapporo Japan
Description
<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Total pharyngolaryngectomy (TPL) is standard treatment for hypopharyngeal cancer. However, extensive thyroidectomy and paratracheal nodal dissection (PTND) can cause hypoparathyroidism. We sought to determine the optimum extent of resection.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We analyzed the clinicopathological information of 161 pyriform sinus cancer patients undergoing TPL from 25 Japanese institutions. Rates of recurrence and risk factors for hypoparathyroidism, as well as incidence of pathological contralateral level VI nodal metastasis and stomal recurrence, were investigated.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The extent of thyroidectomy and nodal dissection were not independent risk factors for recurrence. Incidences of contralateral level VI nodal involvement and stomal recurrence were 1.8% and 1.2%, respectively. Patients undergoing hemithyroidectomy/ipsilateral PTND did not develop stomal recurrence and had the lowest incidence of hypoparathyroidism. Prognosis in patients without tracheostomy prior to hemithyroidectomy/ipsilateral PTND was comparable to that with more extensive resections.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Hemithyroidectomy/ipsilateral PTND may be sufficient for pyriform sinus cancer cases without tracheostomy.</jats:p></jats:sec>
Journal
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- Head & Neck
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Head & Neck 46 (2), 269-281, 2023-11-13
Wiley
